EA Questionnaire Page | Herbal Adjunct, LLC.

Thank you for your interest in the Early Adopter giveaway. Before we send the testing packet, please complete the following form. Once we receive it, we will send out your KetoSavior™ tester packet.

Email*

I have no chronic illnesses and am not on prescription medication:*

I have reviewed my personal information and everything is correct:*

I will use my blood ketone meter to test at least one serving of KetoSavior™:*

In order to qualify for the two free bottles of KetoSavior™, I understand I must email a picture of the ketone meter showing my post-meal ketone level:*

In order to qualify for the two free bottles of KetoSavior™, I understand I must email details of the meal I ate (with macros when possible):*

In order to qualify for the two free bottles of KetoSavior™, I understand I must complete one video testimonial regarding what I ate, what the results were and any comments (good or bad) I have:*

Type in your full name (this is your signature):*

Please enable JavaScript in your browser to submit the form.kadence-form-_8880c8-0b .kadence-blocks-form-field.kb-submit-field { display: none; }

Once we receive the picture of your ketone reading and the details of the meal, we will send you the link to testimonial site (we use videoask.com). Finally, once you complete and we receive the testimonial, we will mail out the two free bottles of KetoSavior™.

We look forward to hearing from you soon!

Best Regards,
The Herbal Adjunct Team

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